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Multiple Sclerosis
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1352458507076952v1
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Article

Optic nerve magnetization transfer imaging and measures of axonal loss and demyelination in optic neuritis

S Anand Trip1*, Patricio G Schlottmann2, Stephen J Jones3, Wai-Yung Li4, David F Garway-Heath2, Alan J Thompson1, Gordon T Plant5, D H Miller1

1 NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, UK
2 Glaucoma Research Unit, Moorfields Eye Hospital, London, UK
3 Department of Clinical Neurophysiology, The National Hospital for Neurology and Neurosurgery, London, UK
4 Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, UK
5 Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, UK

* To whom correspondence should be addressed.


   Abstract

Magnetization transfer imaging is an MRI technique that provides quantitative information about in vivo tissue integrity, including myelin and axonal content, and is expressed as the magnetization transfer ratio (MTR). The optic neuritis lesion can model the MS lesion in vivo and permits use of non-invasive markers of optic nerve myelination (visual evoked potential [VEP] latency) and retinal neuroaxonal loss (optical coherence tomography [OCT]) to provide further information about the in vivo substrates of optic nerve MTR. Twenty-five patients with optic neuritis were studied using an optic nerve MTR sequence, quantitative visual function testing, VEPs and OCT, along with 15 controls. MTR was reduced in affected nerves compared to both clinically unaffected nerves from patients and control nerves (P<0.001). Whole-nerve MTR correlated modestly with central-field VEP latency but more strongly when lesion-only MTR was measured, when a modest correlation with whole-field VEP latency emerged. OCT-quantified retinal neuroaxonal loss also correlated with MTR. In conclusion, markers of optic nerve myelination and axonal loss both correlate with optic nerve MTR. Because axonal loss following optic neuritis also results in myelin loss, the relative contributions of the two pathological conditions to the MTR measures cannot be estimated from this study. Multiple Sclerosis 2007; 00: 000-000. http://msj.sagepub.com

Key Words: magnetization transfer imaging; MRI; optic neuritis; optical coherence tomography; visual evoked potentials

First published on April 27, 2007, doi:10.1177/1352458507076952

Multiple Sclerosis 2007;13:875.

A more recent version of this article appeared on August 1, 2007


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